Knowledge level and frequency of adult vaccinations in elderly population and the effect on change of different education methods, Efeler, Aydin

Title: Knowledge Level and Frequency of Adult Vaccinations in Elderly Population and the Effect on Change of Different Education Methods, Efeler, Aydın Aim: The study has two stages. The aim of the first stage, the cross-sectional study, is to identify the frequency of application of adult vaccinations in older people living in Efeler province of Aydın and to determine the level of awareness, behaviours, attitudes and knowledge about vaccination. The aim of the second stage, the intervention study, is to identify the effect of the different education interventions about vaccinations on the level of participants' knowledge and awareness and the frequency of vaccination after a two month period. It is also to detect the vaccination barriers in unvaccinated older people at the end of the process. Methods: The study was conducted between December 2016 and September 2017. The universe of the study was 25,903 elderly people living in Efeler province. The sample size of the study was 536 in the cross-sectional stage and 120 in the intervention stage. In cross-sectional study, 83 districts were divided into three groups as 'high', 'medium' and 'low'. It was chosen Cumhuriyet District as high socioeconomic class, Cuma District as medium socioeconomic class and Konuklu District as low socioeconomic class. The intervention study's districts were chosen from medium socioeconomic class. It was identified Baltaköy District as family member's intervention group, Dalama District as control group, Imamköy District as midwife education's intervention group and Kadıköy District as peer education's intervention group. After the interventions, the same questionnaire was applied after the two-month waiting period. Findings: Total of 536 people participated at the cross-sectional study. 349 people (65.1%) were living in Cumhuriyet District, 130 people (24.3%) in Cuma District and 57 people (10.1%) in Konuklu District. Mean age of all participants was 71.5±6.2 and no significance was found between the districts (p>0.05). Marital status, person living together at home, education status, occupation, household monthly income and social security status were found significant between the districts (p<0.05). Maximum score of 36 points was obtained with the questions of awareness about vaccines, centres where vaccinations made, application criteria of vaccines, spread ways of influenza, pneumonia and tetanus, frequency of vaccines. Mean points of Cumhuriyet (16.3±5.1) and Cuma Districts (14.2±3.7) were found higher than Konuklu District (10.3±4.9) (p<0.001). The frequency of influenza vaccination in the last 1 year was 26.3%, the frequency of pneumococcal vaccination in the last 5 years was 0,002% and the frequency of tetanus vaccination in the last 10 years was found to be 10.2%. Before the intervention no significance was found between mean points of four districts. After the intervention mean point of midwife education's group was 24.8±3.2, family member's group was 20.7±3.3, peer education group was 16.2±4.4 and control group was 11.2±4.9. Result: Population is aging in our country and vaccination rates are not at the desired level. It is necessary to disseminate the concept of lifetime vaccination and add elderly people to the national vaccination programme. Family health workers especially midwife should give information about adult vaccination particularly at home visits. Key words: Elderly, Vaccination, Intervention Studies